These Common Medications May Put You at Greater Risk for a Heat Stroke
A heat wave is expected in many parts of the U.S. this week.
Certain medications raise your risk of heat illnesses like heat stroke and exhaustion.
Doctors recommend caution if you take these medications.
The National Weather Service is warning about a record-breaking heat that will hit several parts of the U.S. this week. The Midwest, Great Lakes, Northeast, and Mid-Atlantic will see the hottest temperatures of the summer so far. You’re probably aware that heat illnesses, like heat stroke and heat exhaustion, are a risk any time the temperatures soar. But you may not know that certain medications can also increase the odds you’ll struggle with a heat-related illness.
“Knowing that this can happen is the first step,” says Christina Inteso, Pharm.D., a clinical pharmacy specialist at Corewell Health. “From there, you can monitor your body for symptoms.”
Meet the experts: Christina Inteso, Pharm.D., a clinical pharmacy specialist at Corewell Health; Michael Levine, M.D., an emergency medicine physician at UCLA Health; Lewis Nelson, M.D., chair of emergency medicine at Rutgers New Jersey Medical School
So, which medications raise your risk of heat-related illnesses and what can you do if you take them? Doctors explain.
Which medications raise your risk of heat illness?
There are a lot of different medications that can raise your risk of being susceptible to heat illness, and the potential issues they raise can vary. “One of the biggest issues is medications that block your ability to sweat,” says Lewis Nelson, M.D., chair of emergency medicine at Rutgers New Jersey Medical School.
“If you’re not able to sweat, you lose one of your body's normal mechanisms to cope with getting hot,” explains Michael Levine, M.D., an emergency medicine physician at UCLA Health.
Some of these medications are more common than others. Doctors say these are the most common drugs that could increase the odds you’ll get sick in high heat.
Antidepressants
Some antidepressants like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) may impact your body’s ability to regulate your temperature, per the Centers for Disease Control and Prevention (CDC). They may also interfere with fluid balance in your body and increase sweating, raising the risk of dehydration.
Antihistamines
Antihistamines are commonly used to treat allergies and allergic reactions. But antihistamines like promethazine, doxylamine, and diphenhydramine can interfere with your body temperature regulation and tamp down on your ability to sweat, according to the CDC.
Stimulants
Stimulants like amphetamines are often used to treat attention deficit hyperactivity disorder (ADHD). But, research shows that these drugs, which interact with your central nervous system and brain, raise your body temperature, too.
Beta-blockers
Beta-blockers are a class of medications that are mostly used to treat cardiovascular diseases like high blood pressure. But beta blockers can make it harder for people to sweat and appropriately cool themselves in hot weather, according to the CDC. They can also cause low blood pressure, raising the risk of fainting and falls, the CDC says.
Diuretics
These medications help reduce the buildup of fluid in the body, the Cleveland Clinic explains. Also known as water pills, they help your kidneys put extra salt and water into your urine and are often used to treat high blood pressure. But diuretics come with a risk of reduced thirst and excessive urination, which can raise the odds you’ll become dehydrated, the CDC says.
ACE inhibitors
ACE inhibitors are used to treat and manage high blood pressure, which is a big risk factor for heart disease, heart failure, stroke, and more. ACE inhibitors can lower your thirst sensation, making it more likely you won’t take in enough fluids, per the CDC. They also may raise the risk you’ll faint or fall, Dr. Nelson says.
Thyroid hormone replacement medications
Thyroid replacement medications like levothyroxine are designed to raise low levels of natural thyroid hormones in the body, Medline Plus explains. The medication can also raise your temperature and cause excessive sweating, per the CDC. That could increase your risk of dehydration.
Antipsychotic medications
These drugs are used to treat psychosis that can happen with schizophrenia, bipolar disorder, depression, and Alzheimer’s disease, according to the Cleveland Clinic. These medications can raise your risk of heat illness by messing with your ability to regulate your body temperature, making it difficult to sweat normally, and reducing your thirst sensation, the CDC says.
How to stay safe in the heat when you take these medications
If you’re taking prescription medication, it’s important to continue to take it as directed by your doctor, Dr. Levine says. “Don’t not take medications that are prescribed to you,” he says. “If you are going to stop medications, it should be done in conjunction with your physician.”
Dr. Nelson agrees. “You should take your medications, but shouldn’t put yourself in a situation where you could overheat,” he says. If you can, Inteso recommends staying indoors when temperatures get especially high. But if you need to venture out, she suggests that you “try to stay in the shade, consider a portable fan, stay hydrated, and take breaks from being outside.”
Dr. Levine also recommends having a low threshold for getting into cooler temperatures. “Be aware of your surroundings and your body,” he says. “If you start to get too hot, stop what you’re doing and come inside.”
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